Nursing in long-term care

RN Judy Blakely nursed in Ontario and British Columbia and in Hinton in Alberta. In Alberta, you don't go under the health auspices [health system] until you are long-term care, extended care. And prior to that you're under the ministry of housing, which is quite different that you'd find in a British Columbia system. Even in the staff, you find that the staff in British Columbia are wearing uniforms. The staff in housing, which is more geared toward being a residential setting, again providing basically the same kind of care, but different ways of dealing with it. So the girls aren't in uniform in a lot of cases. They're not in blue jeans, but they're not in, they sort of represent more, this is our home rather than this is an institution. Quite a difference.

Generally when you're in a seniors lodge it's PCAs, which is personal care attendants. They do receive some training, but they do not have the designation of the LPN, or in other provinces it's RNA, this type of thing. They do have some education, but not as elaborate. The other thing is that they're not doing hands-on nursing care. They are the people who support everything else except for personal care, and then you have your LPNs and RNs coming in from home care services, which are community-based nursing service run under the health units.

I do want to make sure that the staffing is staying. As we find that we're progressing through a lot of these issues, costs seem to be a big factor. If costs are being taken up by staffing, you see some reduction in the staffing. We're already running, in a lot of cases that I've been involved with, right at the bottom level of how much staff there is. When the regulations say you can have one person on a night shift for x number of residents, that's all you have. 'Cause that's all you can afford to have. In a lot of cases, one person isn't enough. So we really have to have people that are committed to this type of work, because it is a 24-7 work. But we also have to have the means financially to be able to have these people in place. I think that's very important. The other thing that comes into play, especially if you're in a rural or outlying district, you have to have the inspections. You have to have the accessibility to good food at a reasonable cost so you can keep your costs down, and again give the best service that you possibly can to the seniors.

But now there are more and more situations where staffing has been reduced. Staffing has been reduced from RNs to LPNs to PCAs. In a situation where you used to have an RN on the floor at all times 24-7, you now have an RN on call that's not even in the building, that will come in. Or you have LPNs that'll come in to do specific services, not be there all the time. There's been quite a bit of downloading that I've seen over the last few years. It's really sort of a frightening trend more than being something that is an imminent danger. In most places, the residents are still cared for in the best way they can. The seniors are still given the attention they need. There are always some places and some situations that are not as good as others, but basically people are getting good care.